J Neuroeng Rehabil
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Virtual reality (VR) provides interactive multimodal sensory stimuli and biofeedback, and can be a powerful tool for physical and cognitive rehabilitation. However, existing systems have generally not implemented realistic full-body avatars and/or a scaling of visual movement feedback. We developed a "virtual mirror" that displays a realistic full-body avatar that responds to full-body movements in all movement planes in real-time, and that allows for the scaling of visual feedback on movements in real-time. The primary objective of this proof-of-concept study was to assess the ability of healthy subjects to detect scaled feedback on trunk flexion movements. ⋯ The new "virtual mirror" extends existing VR systems for motor and pain rehabilitation by enabling the use of realistic full-body avatars and scaled feedback. Proof-of-concept was demonstrated for the assessment of body perception during active movement in healthy controls. The next step will be to apply this system to assessment of body perception disturbances in patients with chronic pain.
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Review Meta Analysis
Gait speed using powered robotic exoskeletons after spinal cord injury: a systematic review and correlational study.
Powered robotic exoskeletons are an emerging technology of wearable orthoses that can be used as an assistive device to enable non-ambulatory individuals with spinal cord injury (SCI) to walk, or as a rehabilitation tool to improve walking ability in ambulatory individuals with SCI. No studies to date have systematically reviewed the literature on the efficacy of powered exoskeletons on restoring walking function. Our objective was to systematically review the literature to determine the gait speed attained by individuals with SCI when using a powered exoskeleton to walk, factors influencing this speed, and characteristics of studies involving a powered exoskeleton (e.g. inclusion criteria, screening, and training processes). ⋯ Twelve articles reported individual data for the non-ambulatory participants, from which a positive correlation was found between gait speed and 1) age (r = 0.27, 95 % CI 0.02-0.48, p = 0.03, 63 participants), 2) injury level (r = 0.27, 95 % CI 0.02-0.48, p = 0.03, 63 participants), and 3) training sessions (r = 0.41, 95 % CI 0.16-0.61, p = 0.002, 55 participants). In conclusion, powered exoskeletons can provide non-ambulatory individuals with thoracic-level motor-complete SCI the ability to walk at modest speeds. This speed is related to level of injury as well as training time.
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Randomized Controlled Trial
Training finger individuation with a mechatronic-virtual reality system leads to improved fine motor control post-stroke.
Dexterous manipulation of the hand, one of the features of human motor control, is often compromised after stroke, to the detriment of basic functions. Despite the importance of independent movement of the digits to activities of daily living, relatively few studies have assessed the impact of specifically targeting individuated movements of the digits on hand rehabilitation. The purpose of this study was to investigate the impact of such finger individuation training, by means of a novel mechatronic-virtual reality system, on fine motor control after stroke. ⋯ Actively assisted individuation therapy comprised of non task-specific modalities, such as can be achieved with virtual platforms like the AVK described here, may prove to be valuable clinical tools for increasing the effectiveness and efficiency of therapy following stroke.
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Functional imaging studies have indicated that patients with low back pain can have significant reductions in cerebral cortex grey matter. However, the mechanisms governing the nociceptive pathways in the human brain are unclear. The aim of this study was to use functional magnetic resonance imaging (fMRI) and regional homogeneity (ReHo) to investigate changes in resting-state brain activity in subjects that experienced experimentally induced low back pain. ⋯ These findings suggest that abnormally spontaneous resting-state activity in some brain regions may be associated with pain processing. These changes in neural activity may contribute to the recognition, execution, memory and emotional processing of acute low back pain.
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A balance test provides important information such as the standard to judge an individual's functional recovery or make the prediction of falls. The development of a tool for a balance test that is inexpensive and widely available is needed, especially in clinical settings. The Wii Balance Board (WBB) is designed to test balance, but there is little software used in balance tests, and there are few studies on reliability and validity. Thus, we developed a balance assessment software using the Nintendo Wii Balance Board, investigated its reliability and validity, and compared it with a laboratory-grade force platform. ⋯ The balance assessment software incorporating the Nintendo Wii balance board was used in our study and was found to be a reliable assessment device. In clinical settings, the device can be remarkably inexpensive, portable, and convenient for the balance assessment.